Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2021 Nov 3;11(1):21556. doi: 10.1038/s41598-021-01086-9.
The purpose of this study was to investigate whether sex differences in visceral fat volume and glucose uptake measured by positron emission tomography/computed tomography (PET/CT) in abdominal visceral fat can stratify overall survival (OS) in patients with colorectal cancer (CRC). We retrospectively enrolled 293 patients diagnosed with CRC who underwent PET/CT before surgical resection. Fluorodeoxyglucose uptake of visceral adipose tissue (VAT-SUV) and subcutaneous adiposity tissue (SAT-SUV) were measured using PET/CT. The relative VAT (rVAT) was defined as the visceral fat volume normalized to the total volume of fat (VAT plus SAT). We defined sex-specific cutoff values for VAT-SUV, SAT-SUV, and rVAT. Univariate and multivariate analyses using Cox proportional hazard regression analysis were performed to identify the independent prognostic factors. The study population comprised 181 men and 112 women. The rVAT (0.40 vs. 0.29, p < 0.001) and VAT-SUV (0.55 vs. 0.48, p = 0.007) were significantly greater in men than in women. High rVAT (than low rVAT) and high VAT-SUV (than low VAT-SUV) showed a worse prognosis in male and female patients, respectively. Multivariate analysis indicated that the combination of rVAT and VAT-SUV was an independent prognostic factor for predicting OS in both male and female patients. The combination of rVAT and VAT-SUV could differentiate the patients with the best survival outcome from the other three individual groups in female patients, but not in males. Glucose uptake and relative volume of visceral fat may provide a new risk stratification for patients with CRC, especially female patients.
本研究旨在探讨经正电子发射断层扫描/计算机断层扫描（PET/CT）测量的内脏脂肪体积和葡萄糖摄取的性别差异是否能分层结直肠癌（CRC）患者的总生存期（OS）。我们回顾性纳入了 293 名在手术切除前接受过 PET/CT 检查的 CRC 患者。使用 PET/CT 测量内脏脂肪组织（VAT-SUV）和皮下脂肪组织（SAT-SUV）的葡萄糖摄取量。相对 VAT（rVAT）定义为内脏脂肪体积与脂肪总量（VAT 加 SAT）的比值。我们为 VAT-SUV、SAT-SUV 和 rVAT 定义了性别特异性的截断值。使用 Cox 比例风险回归分析进行单因素和多因素分析，以确定独立的预后因素。研究人群包括 181 名男性和 112 名女性。男性的 rVAT（0.40 比 0.29，p<0.001）和 VAT-SUV（0.55 比 0.48，p=0.007）显著高于女性。高 rVAT（与低 rVAT 相比）和高 VAT-SUV（与低 VAT-SUV 相比）分别在男性和女性患者中显示出更差的预后。多因素分析表明，rVAT 和 VAT-SUV 的组合是预测男性和女性患者 OS 的独立预后因素。rVAT 和 VAT-SUV 的组合可在女性患者中区分出生存结局最佳的患者与其他三组个体，而在男性患者中则不能。葡萄糖摄取和内脏脂肪的相对体积可能为 CRC 患者，特别是女性患者提供新的风险分层。
